title: Remote vibrotactile noise improves light touch sensation in stroke survivors' fingertips via stochastic resonance.
abstract: OBJECTIVE
  Stroke rehabilitation does not often integrate both sensory and motor recovery. While subthreshold noise was shown to enhance sensory signal detection at the site of noise application, having a noise-generating device at the fingertip to enhance fingertip sensation and potentially enhance dexterity for stroke survivors is impractical, since the device would interfere with object manipulation. This study determined if remote application of subthreshold vibrotactile noise (away from the fingertips) improves fingertip tactile sensation with potential to enhance dexterity for stroke survivors.
  
  
  METHODS
  Index finger and thumb pad sensation was measured for ten stroke survivors with fingertip sensory deficit using the Semmes-Weinstein Monofilament and Two-Point Discrimination Tests. Sensation scores were measured with noise applied at one of three intensities (40%, 60%, 80% of the sensory threshold) to one of four locations of the paretic upper extremity (dorsal hand proximal to the index finger knuckle, dorsal hand proximal to the thumb knuckle, dorsal wrist, volar wrist) in a random order, as well as without noise at beginning (Pre) and end (Post) of the testing session.
  
  
  RESULTS
  Vibrotactile noise of all intensities and locations instantaneously and significantly improved Monofilament scores of the index fingertip and thumb tip (p < .01). No significant effect of the noise was seen for the Two-Point Discrimination Test scores.
  
  
  CONCLUSIONS
  Remote application of subthreshold (imperceptible) vibrotactile noise at the wrist and dorsal hand instantaneously improved stroke survivors' light touch sensation, independent of noise location and intensity. Vibrotactile noise at the wrist and dorsal hand may have enhanced the fingertips' light touch sensation via stochastic resonance and interneuronal connections. While long-term benefits of noise in stroke patients warrants further investigation, this result demonstrates potential that a wearable device applying vibrotactile noise at the wrist could enhance sensation and grip ability without interfering with object manipulation in everyday tasks.
authors.affiliation: Department of Industrial and Manufacturing Engineering, University of Wisconsin-Milwaukee, Milwaukee, USA. lrenders@uwm.edu.
authors.forename: Leah R
authors.initials: LR
authors.lastname: Enders
authors.forename: Pilwon
authors.initials: P
authors.lastname: Hur
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Johnson
authors.forename: Na Jin
authors.initials: NJ
authors.lastname: Seo
mesh_terms: D000368:Aged; D005260:Female; D005385:Fingers / Q000294:innervation / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012677:Sensation / Q000502:physiology; D012684:Sensory Thresholds / Q000502:physiology*; D013269:Stochastic Processes; D000071939:Stroke Rehabilitation; D055698:Touch Perception / Q000502:physiology*; D014732:Vibration / Q000627:therapeutic use*